Otolaryngology (Ear, Nose & Throat)

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X-Ray Exam: Neck

What It Is

A neck X-ray is a safe and painless test that uses a small amount of radiation to make images of the soft tissues in the neck. During the examination, an X-ray machine sends a beam of radiation through the neck, and an image is recorded on a computer or special film.

This image includes structures such as the vertebrae (neck bones), the soft tissue in front of the vertebrae, and the adenoids and tonsils when they're enlarged. It also shows the oral and nasal airways, the nasopharynx (where those two airways meet), part of the trachea (windpipe), and the epiglottis (the flap of tissue that covers the trachea when people swallow).

The X-ray image is black and white. Dense body parts that block the passage of the X-ray beam through the body, such as the teeth and bones, appear white on the X-ray image. Hollow parts, such as the airways, allow X-ray beams to pass through them and appear black.

An X-ray technician takes the X-ray. When a neck X-ray is taken to view the soft tissues of the neck, usually one picture is taken, from the side (lateral view). An additional picture from the front might also be taken (anteroposterior or AP view).

Why It's Done

A neck X-ray is used to help diagnose problems in the soft tissues of the neck. For example, symptoms such as stridor (noisy breathing), barking cough, and hoarseness may result from swelling of different areas in or near the airway. The neck X-ray can help detect a swollen epiglottis (a condition known as epiglottitis), which is rare, or swelling in the tissues around the vocal cords (croup). It can also help in diagnosing an infection in the area behind the throat (retropharyngeal abscess).

It can detect signs of enlarged tonsils and adenoids, which is useful in the evaluation of kids with obstructive sleep apnea, excessive snoring, or recurrent sinus and ear infections.

It also can reveal masses in the neck, such as cysts and tumors, as well as some types of objects that might have been mistakenly swallowed or inhaled and have become lodged in the upper airway or esophagus.

Preparation

A neck X-ray doesn't require special preparation. Your child may be asked to remove all clothing and jewelry from the waist up and change into a hospital gown because buttons, zippers, clasps, or jewelry might interfere with the image.

If your daughter is pregnant, it's important to tell the X-ray technician or her doctor. X-rays are usually avoided during pregnancy because there's a small chance the radiation may harm the developing baby. But if the X-ray is necessary, precautions can be taken to protect the fetus.

Procedure

Although the procedure may take about 15 minutes, actual exposure to radiation is usually less than a second.

Your child will be asked to enter a special room that will most likely contain a table and a large X-ray machine hanging from the ceiling. Parents are usually able to accompany their child to provide reassurance. If you stay in the room while the X-ray is being done, you'll be asked to wear a lead apron to protect certain parts of your body. Your child's reproductive organs also will be protected with a lead shield.

A neck X-ray may be performed in a standing, sitting, or lying position. This will depend on the condition of your child and the reason for the X-ray. The technician will position your child, then step behind a wall or into an adjoining room to operate the machine. If two X-rays are taken, the technician will return to reposition your child.

Older kids will be asked to hold their breath and remain still for 2-3 seconds while the X-ray is taken; infants may require gentle restraint. Keeping the neck still is important to prevent blurring of the X-ray image.

What to Expect

Your child won't feel anything as the X-ray is taken. The X-ray room may feel cool due to air conditioning used to maintain the equipment.

Positions required for the X-ray may feel uncomfortable, but they need to be held for only a few seconds. If your child is injured or in pain and can't stay in the required position, the technician might be able to find another position that's more comfortable. Babies often cry in the X-ray room, especially if they're restrained, but this won't interfere with the procedure.

After the X-ray is taken, you and your child will be asked to wait a few minutes while the image is processed. If it is blurred or unclear, the X-ray may need to be redone.

Getting the Results

The X-ray will be looked at by a radiologist (a doctor who's specially trained in reading and interpreting X-ray images). The radiologist will send a report to your doctor, who will discuss the results with you and explain what they mean.

In an emergency, the results of a neck X-ray can be available quickly. Otherwise, results are usually ready in 1-2 days. In most cases, results can't be given directly to the patient or family at the time of the test.

Risks

In general, neck X-rays are very safe. Although any exposure to radiation poses some risk to the body, the amount used in a neck X-ray is small and not considered dangerous. It's important to know that radiologists use the minimum amount of radiation required to get the best results.

Developing babies are more sensitive to radiation and are at more risk for harm, so if your daughter is pregnant, be sure to tell her doctor and the X-ray technician.

Helping Your Child

You can help your young child prepare for a neck X-ray by explaining the test in simple terms before the procedure. It may help to explain that getting an X-ray is like posing for a picture.

You can describe the room and the equipment that will be used and reassure your child that you'll be right there for support. For older kids, be sure to explain the importance of keeping still while the X-ray is taken so it won't have to be repeated.

If You Have Questions

If you have questions about why the neck X-ray is needed, speak with your doctor. You can also talk to the X-ray technician before the procedure.

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